矽肺患者合并阻塞性睡眠呼吸暂停低通气综合征的临床特征分析

职业与健康 ›› 2024, Vol. 40 ›› Issue (15): 2017-2020.

• 论著 • 下一篇

矽肺患者合并阻塞性睡眠呼吸暂停低通气综合征的临床特征分析

贺今, 王贝贝, 邱梦茹, 王丽, 刘保岩, 刘燕

山东省职业卫生与职业病防治研究院（山东第一医科大学附属职业病医院,山东省职业病医院）,山东济南 250062

收稿日期:2023-12-13 修回日期:2024-01-08 发布日期:2026-03-17
作者简介:贺今,女,副主任医师,主要从事职业病临床诊疗工作。
基金资助:
山东省自然科学基金（ZR2021MH178）; 山东省中医药科技项目（2021Q082）; 山东第一医科大学学术提升计划（2019QL001）

Analysis on clinical characteristic in silicosis patients with obstructive sleep apnea-hypopnea syndrome

HE Jin, WANG Beibei, QIU Mengru, WANG Li, LIU Baoyan, LIU Yan

Shandong Academy of Occupational Health and Occupational Medicine（Occupational Disease Hospital of Shandong First Medical University &Shandong Province Hospital of Occupational Disease）, Jinan, Shandong 250062, China

Received:2023-12-13 Revised:2024-01-08 Published:2026-03-17

摘要/Abstract

摘要： 目的探讨矽肺患者合并阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hypopnea syndrome,OSAHS）夜间低氧血症发生情况等临床特征。方法回顾性分析山东省职业卫生与职业病防治研究院2022年1—12月住院治疗的经多导睡眠呼吸记录监测检查后确诊OSAHS患者,纳入矽肺患者合并OSAHS的65例为病例组,包括壹期30例、贰期15例、叁期20例3组。同时选择10例不接尘的单纯OSAHS患者作为对照组,观察3组矽肺患者与对照组的Epworth嗜睡量表（Epworth sleepiness scale,ESS）评分、体质量指数（body mass index,BMI）、呼吸暂停低通气指数（apnea-hypopnea index,AHI）、最低血氧饱和度（low oxygen saturation of blood,Low SPO₂）、SPO₂低于90%的时间（time of sleep with oxygen saturation under 90%,T90）、阻塞性呼吸暂停低通气指数（obstructive apnea index,OAI）、肺功能及呼出气一氧化氮（fractional exhaled nitric oxide,FENO）等指标变化,分析3组患者与对照组的临床资料特征。结果与对照组相比,矽肺贰期合并OSAHS患者的AHI[（22.03±6.59）次/h]显著增高、Low SPO₂[（78.27±9.54）%]显著降低（均P<0.05）;矽肺贰期T90[（14.25±8.53）min]、低通气指数[（11.45±5.18）次/h]和叁期T90[（17.09±9.05）min]、低通气指数[（8.85±3.98）次/h]均显著增高（均P<0.01）;病例组3组间比较,与矽肺壹期相比,贰期、叁期AHI、T90均显著增高,且AHI在贰期显著高于叁期患者（均P<0.05）,贰期OAI、AHI均显著增高（均P<0.05）。结论矽肺患者合并OSAHS夜间低氧血症的发生率较不接尘的单纯OSAHS患者增高。

关键词: 睡眠呼吸暂停低通气综合征, 矽肺, 临床特征, 低氧血症

Abstract: Objective To explore the clinical characteristics such as hypoxemia in silicosis patients with obstructive sleep apnea-hypopnea syndrome（OSAHS）. Methods A retrospective analysis was conducted on 65 cases of silicosis with OSAHS diagnosed by overnight polysomnography（PSG） admitted in Shandong Provincial Hospital of Occupational Disease from January to December 2022. A total of 65 silicosis patients with OSAHS were included in the case group,including three groups：Phase Ⅰ（30 cases）,Phase Ⅱ（15 cases）,and Phase Ⅲ（20 cases）. At the same time,10 simple OSAHS patients who were not exposed to dust were selected as the control group. The clinical statistics analysis on the characteristics of patients in the Ⅰ,Ⅱ and Ⅲ stages of silicosis with OSAHS and the control group were assessed by Epworth sleepiness scale score（ESS）,body mass index（BMI）,apnea-hypopnea index（AHI）,low oxygen saturation of blood（Low SPO₂）,time of sleep with oxygen saturation under 90%（T90）,obstructive apnea index（OAI） and fractional exhaled nitric oxide（FENO）,etc. indexes. Results Compared to the control group,the levels of AHI[（22.03±6.59）times/h] were increased significantly and Low SPO₂[（78.27±9.54）%] decreased significantly in silicosis patients in stage Ⅱ complicated with OSAHS（both P<0.05）,the level of T90[（14.25±8.53）min],hypopnea index[（11.45±5.18）times/h] were increased significantly in silicosis patients in stage Ⅱ,and T90[（17.09±9.05）min] and hypopnea index[（8.85±3.98）times/h] were increased significantly in silicosis patients in stage Ⅲ（all P<0.01）. Compared with stage Ⅰ silicosis,the AHI and T90 in stage Ⅱ and stage Ⅲ of the case group were significantly increased,and the AHI in stage Ⅱ was significantly higher than that in stage Ⅲ patients（all P<0.05）. The OAI and AHI in stage Ⅱ were significantly increased than those in stageⅠ（all P<0.05）. Conclusion The incidence of nocturnal hypoxemia in patients with silicosis combined with obstructive sleep apnea（OSAHS） is higher than that in simple OSAHS patients who are not exposed to dust.

Key words: Obstructive sleep apnea-hypopnea syndrome, Silicosis, Clinical characteristics, Hypoxemia

中图分类号:

R135.2

贺今, 王贝贝, 邱梦茹, 王丽, 刘保岩, 刘燕. 矽肺患者合并阻塞性睡眠呼吸暂停低通气综合征的临床特征分析. [J]职业与健康, 2024, 40(15): 2017-2020.

HE Jin, WANG Beibei, QIU Mengru, WANG Li, LIU Baoyan, LIU Yan. Analysis on clinical characteristic in silicosis patients with obstructive sleep apnea-hypopnea syndrome. [J]OCCUPATION AND HEALTH, 2024, 40(15): 2017-2020.

参考文献

[1] 何升印. 尘肺病患者肺功能及血气分析与临床表现的关系[J].职业与健康,2016,32(9):1187-1189.
[2] 中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)[J].中华结核和呼吸杂志,2012,35(1):9-12.
[3] FARRELL P C,RICHARDS G.Recognition and treatment of sleep-disordered breathing:An important component of chronic disease management[J].Transl Med,2017,15(1):114.
[4] MAGALANG U J,PACK A I.Adaptive servo-ventilation for central sleep apnea in heart failure[J].N Engl J Med,2016,374(7):691.
[5] LI X,SOTRES-ALVAREZ D,GALLO L C,et al.Associations of sleep disordered breathing and insomnia with incident hypertension and diabetes:The hispanic community health study/study of latinos[J].Am J Respir Crit Care Med,2020:32758008.
[6] LOCKE B W,LEE J J,SUNDAR K M.OSA and chronic respiratory disease:Mechanisms and epidemiology[J].Int J Environ Res Public Health, 2022,19(9):5473
[7] RODER F,WELLMANN B,BITTER T,et al.Sleep duration and architecture during ASV for central sleep apnoea in systolic heart failure[J].Respir Physiol Neurobiol,2020,271:103286.
[8] 中华人民共和国卫生部.职业性尘肺病的诊断标准:GBZ 70—2015[S].北京:人民卫生出版社,2015:1-15.
[9] WANG M,ZHANG Z,LIU J,et al.Gefitinib and fostamatinib target EGFR and SYK to attenuate silicosis:A multi-omics study with drug exploration[J].Signal Transduct Target Ther,2022,7(1):157.
[10] ANTONAGLIA C,PASSUTI G.Obstructive sleep apnea syndrome in non-obese patients[J].Sleep Breath,2022,26(2):513-518.
[11] 吴毅程,苏丹,林春尧,等.阻塞性睡眠呼吸暂停低通气综合征患者心率变异性与低氧程度的相关性分析[J].中国临床医学,2023, 30(5):812-818.
[12] 张扬扬,乔建瓯.FEV1、PEF、MEF75、MEF50、MEF25实际值/预计值评估哮喘患者气道阻塞价值研究[J].人民军医,2021,64(7):633-638.
[13] JANSON C,GISLASON T,BOMAN G,et al.Sleep disturbances in patients with asthma[J].Respir Med,1990,84(1):37-42.
[14] 罗红辉,刘育良,古晓龙,等.呼出气一氧化氮测定在指导慢性阻塞性肺疾病急性加重患者使用全身激素的价值[J].广州医药,2023, 54(10):58-62.
[15] VINCKEN S,SYLVIA V,DANIEL S,et al.The role of FeNO in stable COPD patients with eosinophilic airway inflammation[J].Respir Med,2021,181:106377.
[16] 贺今,王丽,刘光峰,等.全血高敏C反应蛋白和呼出气一氧化氮浓度测定对尘肺病的临床意义[J].中国工业医学杂志,2021,34(6):501-504.
[17] JIA Y,WEN J,QURESHI R,et al.Effect of redundant clinical trials from mainland China evaluating statins in patients with coronary artery disease:Cross sectional study[J].BMJ,2021,372:n48.

矽肺患者合并阻塞性睡眠呼吸暂停低通气综合征的临床特征分析

Analysis on clinical characteristic in silicosis patients with obstructive sleep apnea-hypopnea syndrome

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 6

编辑推荐

Metrics

[1]	薛万腾, 吕志慧, 王坤, 王侨欧, 张松涛, 刘善收. 热射病早期临床特征和死亡高危因素的真实世界研究[J]. 职业与健康, 2025, 41(20): 2817-2821.
[2]	胡洁, 胡在方, 周国伟, 张丽, 甄国新. 北京市某区职业性尘肺病患者现状调查[J]. 职业与健康, 2024, 40(5): 609-612.
[3]	高伟, 焦柯影, 何新蕾, 郝瀚. 应用生物信息学从铁死亡角度筛选治疗矽肺病的天然药物成分[J]. 职业与健康, 2024, 40(14): 1889-1894.
[4]	尉红, 王长勇, 刘冰, 王英. 2006—2022年泰安市职业性尘肺病流行病学特征分析[J]. 职业与健康, 2024, 40(13): 1758-1763.
[5]	金鑫. 2015—2020年长治市新发尘肺病流行病学特征分析[J]. 职业与健康, 2024, 40(1): 119-121.
[6]	刘晨, 王瑞彬. 职业性尘肺合并胸腔积液的相关临床特征分析[J]. 职业与健康, 2023, 39(1): 15-18.